HomeMy WebLinkAboutX2021-1998 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
( Comm'I Residential City of Newport Beach - Building Division ;�L. � m 1 � °t 6 a
NOTE: PLAN CHECK FEES D11F AT TIMF (1F SI IRMIT AI
F -Building r Grading F -Drainage [`Elec F - Meeh , j Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) r Flood F_ Fire F- Liq F_ Landslide [_N/A ' Floor Suite No
-CS O l�"1 V1 Q l"'�1 L% �5� �l!?/� 71 I�t'czvL w
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Description of Work
Use I— Const Type
(�j- to rl, Yofl vn Y-eYvt �G� -Z �
#StoriesW' Units (if Res)r—
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Valuation $ Material/Labor
New/Add SF�---- Remodel SF�- Garage/New/Add �
OWNER'S NAME Last C YZ_ First
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Owner's Address Owner's E-mail Address
2 8 v Pt ra l -[ C, K e Gb ; Y(4 Sl Cj y -e ., hAPt olp t' z/, c� �
City �q. cli lyl of P.4 . State _61V Zip . Telephone v /� 3
APPLICANT'S NAME Last % First S%tw1/%�
Applicantt's Addressn Applicant's E-mail Address
Z � V� ' ✓l Z [ tJt vt �L � ���
City " ;�.<,,7_ ' CCL State r ZipF Telephoned----
ARCHITECT/DESIGNER'S NAME Last y� y First f c ` / (I
r \A t I va s oot w Lt , Lic. No. 6 �
Fr
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Architect Designer's Address Architect/Designers E-mail Address
City. State--.:. Zip �— Telephone_—
ENGINEER'S NAME Last First-- Lie No.r-
Engineer's Address Engineer's E-mail Address
City State r— Zip r-- Telephoner——
CONTRACTOR'S NAME/COMPANY Lic. No. �— -- Class
Contractor's Address Contractor's E-mail Address
City r- Stater--- Zip r-- — Telephoner--
SETBACKS REAR SETBACKS FRONT : PERMIT N0. Yu Z,t
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE ,PG-- t.- DEVELOPMENT NO PLAN CHECK FEES $